| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS INS SERVICES INC | PO BOX 632886 CINCINNATI, OH 452632886 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | $53 | $5K | 7.02% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 13.43% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $967 | $5K | 18.28% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $954 | $4K | 13.44% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS INSURANCE SERVICES | PO BOX 632886 CINCINNATI, OH 45263 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 13.96% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS INSURANCE SERVICES | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $239 | $239 | 0.89% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE | 1765 E SKYLINE DR TUCSON, AZ 857181162 | VISION SERVICE PLAN | $348 | — | $348 | 2.18% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS INSURANCE SVCS INC | PO BOX 632886 CINCINNATI, OH 452632886 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $502 | $2K | 13.45% |
| R AND T FIGUEROA LLC3 Filed as: R & T FIGUEROA | 7569 S CARLISLE AVE TUCSON, AZ 85746 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $489 | $45 | $534 | 5.31% |
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST KANSAS CITY, MO 64112 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $302 | $17 | $319 | 3.17% |
| CAROL JEAN HALL3 | PO BOX 15158 TUCSON, AZ 85708 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $196 | $6 | $202 | 2.01% |
| CAROL VAN3 | 3120 WINDJAMMER DR COLORADO SPRINGS, CO 80920 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $172 | — | $172 | 1.71% |
| EC BENEFITS INC3 | 8038 S 38TH PL PHOENIX, AZ 85042 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $165 | — | $165 | 1.64% |
| VINCENT TAYLOR ECHOLS3 | PO BOX 594 THATCHER, AZ 85552 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $37 | $9 | $46 | 0.46% |
| JOSEPH QUINTANA3 | 27 N COUNTRY CLUB DR PHOENIX, AZ 85014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.21% |
| BILL HIGHSMITH3 | 9234 N 32ND PLACE PHOENIX, AZ 85028 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.11% |
| REYNALDO R GRAJEDA3 | 4915 CAMINO DE MONTE NE ALBUQUERQUE, NM 87111 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.05% |
| BST COMPANIES INC3 Filed as: BST COMPANIES | 481 E DOWTOWN ST TUCSON, AZ 85701 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVSCAREMARK EIN 05-0340626 OTHER SERVICES | Other services Service code 49 | — | $78K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSOR | Claims processing Service code 12 | — | $71K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 331 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 331 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 13 | $10K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 335 | $68K |
| Vision | VISION SERVICE PLAN | 51 | $16K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 291 | $44K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 291 | $38K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 291 | $40K |
| Other(4 contracts, 3 carriers) | GERBER LIFE INSURANCE COMPANY | 331 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 335 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.